Historians have normally mentioned disease only in passing. There is increasing evidence that disease at time has had a major impact on historical events. We have noted several different diseases that have had a major impact on history. The most obvious is the plague. Smallpox had a huge impact on Native Americans. There are references to duseases in historical sources. Before the 19th centurty, however, it is not always possible to ascertain just what disease they were discussing. Historians have used the symtoms described to dertermine the disease, but often the sympthns are not described with adeqequate speficity. Some diseases affect the entire population. Other diseases specifically affect children, or more accurarely, children are more vulnerable to certain diseases. Here the most obvious is polio. In addition, the way to combat several endemic diseases in the innoculation of children which is done before they begin school.
Aids was first discovered as a disease of homosexual men in America. Then because of a lack of appropriate procedures in blood collecting, a number of children were infected. The most famous in america was Ryan White. Many of these children were shuned. The disease is contained in Western countries through drug therapy. Many other countries face very serious problems. Because men in Africa refuse to take need precautions, large numbers of women in Africa are now infected. As a result, substantial numbers of children have also been infected or orphaned. Most of these people are poor and can not afford expensive drug therapy. People in other areas are alsp affected, but the problem is especially severe in Africa.
Autism is probably the most serious disease affecting modern children. It is also the least well understood of all modern diseases, including AIDS and cancer. It is a diease that has only recently been identified. Autism was first identified by Leo Kanner (1943) Earlier auistic children were commonly diagnosed as mentally retarded and confined to various mental health institutions. Even after autism was isentified, it was a disorder that few parents were aware of for many years. We have seen many estimates as to the prevalence. One source suggests that about 1 in 500 Americans are affected to varying degrees by autism. We have seen other estimates than the prevalence may be as much as 1 in 200 or even higher.
These are very high numbers, much higher than other diseases. This long ignored disease in attracting increasing pubkic attention, in part because of the work of parents. The U.S. Congress has approved a major research effort (2006). For some still unexplained reason that boys are four times more likely than girls to be affected. No one knows why, but probably related to the fact that more boys are likely to have very high IQs and suffer from mental retardation. There is strong evidence that autism is at least in part an inherited disorder. Autism is included in the general category of Pervasive Developmental Disorders. There are different forms of aurism as well as levels of severity. Children also vary as to when autism begins to affect their behavior. Aurtism affects coomunications, social interaction, sences, play, and behavior. Caring for critically ill children is wrenching experience for any parents. Of all the discorders discussed here, caring for a austistic child may be the most difficult. [Moore]
The work of Jenner, Salk, and Sabin is realitively well know. The story of Maurice Hilleman (19??-2005) is virtually unknown to the modern reader. We are not sure why given his accomplishments. He worked for most of his career at the American pharmaceutical company Merck. There is a tendency today to denegrate scientists and left-wing moralists have made drug companies a favorite target. (In the modern editorial tirades against the drug companies, note that there is a stunning silence about the disease cures developed by socialist states--primarily because they did not make any major medical advances.)
Hilleman and Merck's accomplishments are, however, phemonenal. As a young researcher, Hilleman began working on a vaccine for Japanese encephalitus when Ameruican soldiers in the Pacific began contracting the disease and rising mortalities were reported. Hilleman oversaw an operation which harvested 30,000 mouse brains daily which were then pricessed by blenders. Merck began shipping adequate vaccines to protect 0.6 million men in just 3 months. That alone would have been enough for most scientific careers, but for Hilleman it was just a beginning. When his 5-year old child got the mumps he swabbed her throat and went immeditely to his lab. The result was the first mumps vaccine (1963). He went on to develop vaccines for German messales, hepatitis A and B, and chicken pox. [Offit]
Diphtheria is a potentially deadly bacterial infection which acts on the mucous membranes of the nose and throat. It is psrticulsrly serious as it is a contsgeous disdease. Diptheria commonly begins a sore throat leading to fever, swollen glands and general weakness. While these symptoms may be caused by other pathologies, the sure sign of diptheria is a sheet of thick, gray material which covers the back of the throat. This material can build up to the extent that it clogs the windpipe, making it difficult to breath properly. We do not know much about early history. Mechical diagnosis before the 19th centurty were imprecise. The disease was named by French doctor Pierre Bretonneau (1850s). For several decades there was no effective medical treatment. Once it was identified medically we see many examples being reprted. One of the most famous incidents is that is Queen Victoria's daughter Princess Alice and her family becoming infected with it, resulting causing two deaths, Princess Marie of Hesse and by Rhine and Princess Alice herself (1878). It was a deadly disease and even in a search of the HBC data base we find considerable evidence that it was both widespread and deadly. Because photography was developed at about the same time that the disease was identified, we see family members noting deaths on the back of portraits. As late as the 1920s, there were an estimated 0.1-0.2 million cases of diphtheria reported annually just in the United states, resulting in about 15,000 deaths. Children represented a great majority of the cases, apperently because thry did not have a fully developed immune response cpbility. A noted outbreak occurred in Nome, Alaska. The abnti-toxin was finally delivered by dog sled which is now celebrtd by Iditarod Trail Sled Dog Race. One of the first effective treatments for diphtheria was developed by U.S. physician Joseph O'Dwyer (1880s). Diphtheria is no longer a major threat in developed coutries because of the widespread vaccination effort.
Some diseases are ofrelatively modern origin, although this is of some debte among medical hisorians. They puzzel over ancienct texts desribing the symptoms of sickness. They attemt to identify the diseaseinvolved a trivkly proposition given the fact that many of the texts date back not just centuries, but millenia. This is a difficult undertaking as historical names have nothing to do with modern medical terminology. Modern doctors stress the importance of personal examinations. It seems clear, however, that the influenza is as old as civilazation, at least in the Eurasia. We find accounts that seem very much like flu in earliest written texts. Infuenza symtoms were described by Hippocrates roughly (4th entury BC). Historians are convinced that the influeza virus have caused epidemics throughout history. Historical accounts data on influenza are difficult to interpret, because the symptoms are the same as other respiratory diseases. The disease does not appear to have been present in the Aameicas, suggesting that it may nt have been revalent in Eurasia at the time that Siberian hunter began to cross the Bearing Sea land passage.
The inflenza virus dis arriv in the Americas ith the arrival of Columbus (1492) followed by other Eurpeans. and other Europeans. An epidemic with symtoms resembling inflenza was reported (1493). In only a few decades vurtually the entire ideigenous population od the Caribbean was decimated, although influenza wa not the only disease involved. Smallpox was another deadly killer. The first actual epidemic that medical historains are almost unamimously began in Russia (1580) and appears to have spread to Europe via Africa. Some 8,000 people died in Rome. Several Spanish cities were devestated. Doctors use the term pandemic because it was so widespread. There were pandemics reported occasionally (17th and 18th centuries) The most serious infected something like a quater of those exposed (1830-33). The most virulent outbreak known to history was the flu pandemic that occurred at the end of World War I (1918-19). It was inaccuately labeled the Spanish flu pandemic. It was a type A influenza (H1N1 subtype). The number of people wjo died is not known with any certainty. We knowthat millions died, but estimates are widely spaced (20 to 100 million people). Historians describe it as 'the greatest medical holocaust in history'. It may have killed as many people as the Black Death, although perhaps not the same proportion of the popultion. The flu pandemic occured in Europe and North America in the aftermath of World War I (1918-19) and spread worldwide, including plces as remote as Samoa. One of the problems was that because of the War millions of people were malnourished, lowering their resistance to dusease. Large numbers of men in the military lived in crowded barracks or filthy trenches, perfect conditions for spreadung the flu. The flu mutated to an extremely deadly version which also spread to America. Science knew next to nothing about viruses at the time.
The medieval plague, commonly referred to as the Black Death, was the most cathestrophic epidemic in recorded history. The plague is believed to have been brought west from China. Europeans had no resistance to it in much the same way that smallpox brought by Europeans was to desimate Native Americans in the 16th and 17th centuries. The plague ravaged Europe from 1347-51. There were also serious subsequent outbreaks as well. The plague often killed whole families, in part because family members could not bring themselve to abandon each other. Villages were devistated. An estimated 1,000 villages were completely destroyed. Historians estimate that about one-third of the European population died in the plague. The plague, however, had a profound impact on Europe beyond the incalcuable human pain and suffering of those affected. As strange as it may sound, the plague set in motion cultural and economic trends that played a major role in shaping modern Europe.
One other interesting topic is the development of polio in the 20th century and the huge impact it had on children. Polio (poliomyelitis) is a disease modern children have probably never even heard about. It is certainly one their grandparents know all too well. It has a unique history. It was almost never reported before the 20th century and then after the turn of the century, quickly became one of the most feared diseases. Certainly the disease existed before the 20th century. Ironically poor sanitation may have exposed children to it so that they developed an immunity. Impriving sanitation in the early 20th century seems to have reduced this natural immunization process. The disease was particularly feated because it was so poorly understood, struck randomly, and most insidious of all mostly affected children. By the 1930s-50s huge numbers of children were being stricken by polio. Horific images of children clinging tgo life in iron lungs haunted parents with small children. Medical studies suggest that millions of children were affected. There are about 0.6 million living sxurvivors in the United states alone. Finally Dr. Jonas Salk developed an effective remedy. Polio no longer exists in American and other developed countries and a worldwide eradication is underway.
Joseph Meister was a normal little 9-year old French boy. One day he went to played and passed into history. He was bitten by a rabid dog. By all accounts he should have died, had it not been for famed scientist Louis Pasteur (1822-95). Pasteir picked up on the work of Edward Jenner in England. Pasteur afer working with crystals began to work on bacterial. He disproved the idea of spontaneous generation. As a result of his work on bacteria, he inoculated a boy against rabies. We do not yet know about the details of Joseph's later life. Pasteur went on to develop a process to make Milk safer to drink, today known as Pasteurization.
A serious disease affecting children is rickets also known as rachitis. It is a dietary deffiency disease primarily affectng infants and children. A defiency of vitamin D impairs the ability of the body to metabolize calcium. Because the disease is caused by dietary defiency, it is thus often associated with poverty. This leads to a softening of the bone structure and resulting deformities. Children are especially affected because their bones are developing and thus rickits can lead to life-long deformities. The disease can be prevented by adequate intake of vitamin D, calcium, and phosdphorous. It is the primary reason that vitamin is commonly added to milk.
One of the least remembered major disease outbreaks illnesses -- sleeping sickness. Modern reseachers prefer to cally it the sleepy sickness. America was affected about 1916-25. Millions of people were affected worldwide. It is not widely known today because it more or less conincided with a much more deadly eoedienic -- the Spsnjuish Flu or Inflensa epidemic which killed some 50 million people. Many people recivered from the Sleeping Sickness, although often with life-long affects. Some 1 million deaths wre recorded, certainly a huge disater, but somehow pailing when compared to the twin dissters of World War I and the Spanish Flu epidemic. The sleeping sickness had a special horror, many victims trapped inside unresponsive bodies. Children and for some reason omen were the most affected. The initial indication was a sore throat, fever, and a headache. This was followed by more bothersome symtoms like double-vision and a feeling of weaknes. Then tremors, eratic body movements, muscle pains, and slowed mental functioning. hese symptoms soon increased in severity, and in spite of medical attention, most patients worsened dramatically. Finally notable behavioral changes occurred like psychosis and hallucinations and drowsiness and lethargy from which the disase received its name. In the most severe cases, victims became comatose and unresponsive or died. Medical science atvthe time was baffled by the bizarre epidemic which was alo the case for influnza. The cause of influenza was soon discovered. The cause of the sleeping sickness has yet to be determined with ny certainity. Inlike inflenza it does not appear to have been viral. It was assigned the scientific nme of Encephalitis lethargica, literally 'inflammation of the brain that makes you tired'.
Smallpox was a virulent disease which ravaged mankind, one of the five deadliest diseases aflicting mankind. It is an acute contagious disease caused by the variola virus. Expers estimate that it has killed some 300-500 million deaths in the 20th century alone. Transmission occurs through inhalation of the airborne virus, most commobly through droplets dispersed from the oral, nasal, or pharyngeal mucosa of an infected person. The symptoms include a blistered rash on the skin and a fever. Many Europeans who sirbived the disease were marked with scared faces and might even be blinded. Native Americans who had no resistance to the disease were devestated when Europeans brought the disease to the New World. It was one reason thast very small European forces were able to bring down powerful Amer-Indian empires like the Aztecs and Incas. There is no exact account, but perhaps 95 percent of the Native American population appearsto have perished. Smallpox was a major reason for it. Even among people of European ancestry it was feared. Smallpox was the most feared disease, often called 'distemper' in colonial America. Benjamin Franklin was a fervent advocated for 'inoculation' -- a precursor to modern vaccination (1730s). He used his publications in the casuse. It was till very controversial, considered by many to be the work of the devil. And there was a realtively high death rate from the procedure. The Franklin family was ireperably damaged when they lost their beloved son Franky after Deborah opposed innovulation. The Adams family was saved because Abigale dececision to risk the procedure. More importantly, Washington's who had contracted smallpox in Barbados, mafe the risky decision to innoculate the Continental Army almost certainly sabing the American Revplution. Smalkpox was ebdemic in Engkand and the British had herd immunity. the Americans did not. Edward Jenner (1749-1823) developed a cure by developing an actual vaccine using cowpox (1796). James Phipps was the English boy that Jenner used as an experimental subject. The principle was to introduced dead or weakened weakened disease bodies to the individual to help the person's imune system the ability to deal with the disease. Cowpox was a less virulent form of the disease, but helped the system build a resistance to smallpox. Vaccination eventually eliminatedthedisease in the United States and Europe, but was still common in the developing world. The World Health Organization began an irrdication campign (1959). It failed but was relaunched (1967). Within a decade Asia andLstin America was smallpox free. It took a little longer in Africa. The technique of innoculation or vaccination was used to combat many other diseases. It led to a great debate when scientists began to work on a polio vaccine after that disease became a huge problem in the 20th century, crippling thouands of children annually. Dr. Albert Sabine worked on a polio vaccine using a weakened firm. Jonas Salk argued, however, that polio was to virulent for this approach.
Epidemic typhus has been a serious contagiius disease in modern times. It is aproblem when are crowded together in filthy, cold, conditions. It is assicuated wiuth poverty, malnutrurion, war, and famines along with wars, famines, refugees, jails, and ships. Duyrring Wirkld War II it was a problem in concentration camps. Recognizable descriptions of the disease have been found in European literature from the late-Middle Ages. The first reliable description of the disease appears during the Spanish siege of Baza against the Moors during the War of Granada (1489). This is importabnt because it was before the Sopanish were in conatact with Aner-Indians if indeed this was a typhus outbreak. Subsequently there were deadly outbreaks occurring intermittently throughout Europe (17th, 18th, and 19th centuries). The fact that the major outbreaks occured after contavt with Aneri-0Indians leads us ytaklke Granada repoer with some susipcion. Prominent outbreaks occurred during bith the Napoleonic Wars (1800-15) and the Irish Potato Famine (late-1840s). of 1846–49. Epidemic typhus is similar to typhoid fever, but was clearly differentiated (19th century). Major progress in combating the disease began only in the 20th century. French physician Charles-Jules-Henri Nicolle demonstrated that typhus is transmitted from person to person by the body louse (1909). The discovery led to a Nobel Prize. Typhus deckined as a najoir duswase in western Europe and North America as a result of improving living conditions and personal hygiene became increasingly common. The disease continmu=ued to occur in Eastern Europe, the Middle East, and parts of Africa. During World War I thyphis caused several million deaths in Russia, Poland, and Romaniavin military and POW camps. During World War II it caused epidemics among refugees and displaced persons, was particularly deadly in German concentration camps. The disease has been largely eliminated from countries modern insustrail countries, bur os still oresenbt in the highlands of poor countries with inadequate public health systems.
One particularly dangerous disease which became a major danger fior children in the late 19th century was tuberculosis, often called consumption at the time. The disease was especually accute in the unhealthy conditions of urban slums. At the time doctors did not have modern anti-biotics to fight the disease. That did not come until World War II. British scientists developed anti-biotics and American drug companies developed the methods to mass produce them. They have saved millions of lives, but today disease strains are energing that are immune to all anti-biotics.
Diamond, Jeremy. Gun's, Steel, and Germs.
Moore, Charlotte. George and Sam: Ywo Boys, One Family, Autism (St. Martin's, 2006), 320p.
Offit, Paul A. Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases (Smithsonian, 2007), 254p.
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